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Avoiding a "big" baby: Local perceptions and social responses toward childbirth-related complications in Menabe, Madagascar

hal.structure.identifierCentre population et développement [CEPED - UMR_D 196]
hal.structure.identifierUniversité Paris Descartes - Paris 5 [UPD5]
hal.structure.identifierInstitut de Recherche pour le Développement [IRD]
hal.structure.identifierInstitut National de la Santé et de la Recherche Médicale [INSERM]
dc.contributor.authorPOURETTE, Dolorès
hal.structure.identifierMuséum national d'Histoire naturelle [MNHN]
dc.contributor.authorPIERLOVISI, Carole
hal.structure.identifierUniversité d'Antananarivo
dc.contributor.authorRANDRIANTSARA, Ranjatiana
hal.structure.identifierUnité d'Epidémiologie [Antananarivo, Madagascar] [IPM]
dc.contributor.authorRAKOTOMANANA, Elliot
hal.structure.identifierUnité d'Epidémiologie [Antananarivo, Madagascar] [IPM]
hal.structure.identifierCentre population et développement [CEPED - UMR_D 196]
dc.contributor.authorMATTERN, Chiarella
dc.date.issued2018-12
dc.identifier.issn0037-7856
dc.description.abstractEnIn Madagascar, a country where over 60% of deliveries are not attended by a healthcare professional, late or inadequate responses to complications during childbirth account for a great number of maternal deaths. In this article, we analyse local perceptions of birth-related risks and strategies used to avoid these risks or manage complications of childbirth. We conduct this analysis in light of the social meanings of childbirth and the social expectations placed upon women in a context of socioeconomic vulnerability and a challenged public health system. We conducted two separate studies in the district of Morondava (Menabe region) in June 2014 and March 2015, comprising semi-directive interviews with 111 people (59 mothers, 18 members of their immediate en-tourage and 34 institutional or healthcare stakeholders), and eight focus groups discussions-two with community leaders, and six with fathers. The results show that the social pressure exerted on women to give birth without complications leads them to practices aimed at avoiding a "big" baby including dietary restrictions, physical activity, and refusal of iron supplementation intake. During pregnancy, women are usually accompanied by a traditional birth attendant or matron (reninjaza). Further, they use the public health system by attending antenatal consultations. However, women are reluctant to deliver in a health facility, where the practices of health professionals are in discordance with the social realities of women and local beliefs around childbirth. If complications arise, they are explained by social causes. The parturient woman is only taken to a healthcare facility after carrying out rituals and if the problems do not resolve themselves. These findings support recommendations to reduce the cultural distance between health workers and childbearing women, strengthen the collaborations with reninjazas, and inform women and their decision makers (mother, reninjaza, spouse) about nutrition during pregnancy and signs of complications.
dc.language.isoen
dc.publisherElsevier
dc.subject.enAnthropological approach
dc.subject.enChildbirth-related complications
dc.subject.enLocal knowledge
dc.subject.enMadagascar
dc.subject.enMaternal mortality
dc.subject.enPregnant women's care pathways
dc.title.enAvoiding a "big" baby: Local perceptions and social responses toward childbirth-related complications in Menabe, Madagascar
dc.typeArticle de revue
dc.identifier.doi10.1016/j.socscimed.2018.10.002
dc.subject.halSciences de l'Homme et Société/Sociologie
dc.subject.halSciences du Vivant [q-bio]/Ecologie, Environnement/Santé
dc.subject.halSciences de l'Homme et Société/Anthropologie biologique
bordeaux.journalSocial science & medicine
bordeaux.page52 - 61
bordeaux.volume218
bordeaux.peerReviewedoui
hal.identifierpasteur-01909326
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//pasteur-01909326v1
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